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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> SITE ADDRESS: , n.� PROPERTY TAX►i PERMIT# <br /> � C� � I � �(�= �'T' ( D `�` � <br /> LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br /> owrvER �(,1�ClC� �►���- 1f J� Phone/E-mail �}ZS-24"0 -2`-f Z`� ` ��P( ��iUqc���'�'�'�,� � <br /> Address � 5j^(�,�'(�. ti'�.. City/State/Zip ' d S U� (l< <-+/6�- �t � Z�C <br /> APPLICANT:_Owner _Owner's Agent _Contractor _Contractor�S Ag@Ilt _TBflOflt(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR t��C� ,j1 v��'\�E'�j State Lic.# -�U���� �+�����ty Bus. Lic.# O <br /> Address ��(�� 7 7�`� ��l'= �� �C�✓ �l l,� 7�� Phone/Email <br /> TENANT BUSINESS NAME CONIACT FOR PERMIT 5;, <br /> ,���' ( c{Z�—Z`f C'� ' � �j j <br /> Phone/E-mail 5 U C-'� ��'1 C{UC��J�'� �`j'�F'+�!� l �'✓`'7 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building � �-�(�'� HEAT SOURCE: <br /> Proposed Use of Building Gas_ Electric Other_ <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> T e of ro'ect: New Addition Remodel Re air T.I. Si n S rinkler Demolition Chan e of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> ���' �'l�"` sf'�� � G,'•c��-4 C�I Fc'� j� � `t `I � <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration_Repair Type of Project: _New_Addn _Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of Fxfures <br /> A/C—air handlin units Toilet <br /> Forced air s stems Bathtub <br /> Gas i in Lavato wash basin <br /> Water heater Shower <br /> Gas fire lace Kitchen sink&dis osal <br /> Gas ran e Dishwasher <br /> Clothes d er Clothes washer <br /> Ran e hood Water heater <br /> Exhaust fan Sink service/bar/mo /etc. <br /> Heat um Backflow reventer <br /> Unit heater Urinal <br /> � Boiler Drinkin Fountain <br /> Refri eration Floor drain <br /> � Woodstove Grease tra <br /> Ductin Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM � Other: <br /> Number of Heads Other: <br /> I hereby certify lhat I have read and examined this application and know the same to be true and correcl.All provisions of laws and ordinances governing this type of work will be compl <br /> with whether specified herein or not.The granfing of a permit does not presume to give authonty to violate or cancel the provision of any oiher state or local law regulating construction <br /> Th authonzed by the own of thi property to periorm the work for which application is made and I comply with the State Contractors Law 1827 RCW and 296.200A WAC. <br /> � -G "'t � <br /> O nerl utho z gent Si n tur Date (Revised 9/2014) <br /> �1 <br /> � <br />